| NPI | 1700482478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2020-0112) |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2024-10-08 |